PCOS question: high LH to FSH ratio, but normal estrogen/progesterone/testosterone

I know there's been a few PCOS questions on here lately, but I wanted to start a new post because it seems something odd is going on with my hormone levels. Hopefully some specialists, doctors or those with very similar problems can weigh in.

I'm now 24, 161cm (5"2) and 52-53kg. I have a desk job but cycle about 15km every day, do bikram yoga about 3 times a week.

I first menstruated when I was 14, but after only a few it stopped for 3 years. [Extra detail- I went vegetarian around the same time and had a "mild" eating disorder- skinny but not scarily so]. The doctors then did an ultrasound, but it was only to check if I had ovaries or not. They put me on the pill to "regulate" my period. I stayed on it for six years, mainly liking the contraceptive element on it, but started to feel uneasy about being on it longterm, even though I don't want children.

I came off it in January 2010 and apart from light spotting in April, haven't had a natural period since. I went Paleo around the same time so was hoping that that would kick it back into balance- it didn't. So I went to the dr last month (I now live in Japan) and her ultrasound brought up cysts. She mentioned PCOS but didn't say whether I had the syndrome or "merely" the cysts. Gave me the pill, took a blood test and told me to come back when I bled.

I went back yesterday and saw a different doctor at the clinic. My blood test results were:

Basically, my LH is three times higher than FSH, while they should be the same. She said everything else was in "normal" levels (though for what stage of the cycle, I don't know).

She then gave me ten days of Premarin (which I hear is used mainly for menopausal women!) and ten days of the same pill I had last time- a Japanese one called Sophia-A.

I asked her about the cysts and she said there wasn't really a way to directly treat them and for now it's important to get my cycle back.

However, although I know bleeding is important for uterine health, I don't really want to take the pill. She gave no indication of how long I might be on them or what the next step would be. I also wonder if they actually only encourage dependence rather than naturally kickstarting my hormones again. The last month I have been very emotional and tired and have gained weight around my thighs and hips, which makes me feel dreadful. I was also waking up every 2-3 hours at night, often hungry (perhaps the cause of the weight gain!) and felt like a zombie for much of it.

I felt better after going to an acupuncturist about two weeks ago and being diagnosed with "stagnant liver qi" which is apparently implicated with hormonal issues. However, I have also heard that Chinese medicine does not recognize hormones and so might not be able to pinpoint my own issues.

One choice is not to take the pills, but then I think I would not be able to go back to the same clinic. I speak Japanese but don't really know where to go about finding a different, or "better" doctor. I have not been told whether I merely have cysts or whether I have PCOS, but as I am not overweight, I don't think I have insulin resistance.

I want to know if anyone has recovered from PCOS from being given hormone pills, or whether they are just to address the amenorrhea and to encourage the shedding of the uterine lining. I fully believe in acupuncture but want encouragement that this is the path to take... other than that, taking fish oil, lots of fat, meat, fish and veggies etc (recently really cut down on eating nuts and fruit) has not worked so far. What should I do?

You need to fire your TCM practitioner as well. TCM treats SYSTEMS not symptoms, which is much better way to solve a problem. Your body is a system, not a petri dish. If your practitioner hasn't learned how to treat PCOS, I'd be surprised if they passed their board exams.

I'm with Quilt here. Often times the Pill is prescribed to maintain uterine health. But... it is not the be all end all of treatment. Get new MD and an ultrasound of your ovaries. THEN, start to treat with medication. Acupuncture can be helpful to treat this, but get more information first.

Could you give me any further details, Dr K?
I emailed my acupuncturist and he told me to take the pill as western medicine is better for "specific" things such as fixing the lh/fsh ratio. And continue coming to as it will create an overall balance/equilibrium to bring me back to health.

I am interested to hear responses to your question...it seems a standard response for period problems just to put women on pill! Have you earlier blood test to compare these with? At least acupuncture isn't going to be harmful, I had a session last night for similar issue, holding off on pill for the moment.